In message <[log in to unmask]>, Peter Johnson
<[log in to unmask]> writes
>Is this really the way to treat people who call for urgent help?
>What would have happened if we had not had special knowledge, or if we'd
>been meek? Where has the human, caring, understanding approach gone? Do GP's
>realise how difficult it is for a parent to present a clear case history
>when they've been up all night, and are convinced that their precious child
>is about to expire? Especially when the GP is being hostile.
>
>I'm still *** angry. If you can't do your job properly, you should do
>something else.
>
>I know life is tough at the moment. Trouble is, I've heard lots of similar
>stories recently, and I think the public sympathy for GP's is wearing very
>thin.

This is the kind of story which makes me shudder, because I'm only too
well aware that, for much of the time, many of us are very close to
reacting as your GP's practice did. For the last couple of weeks, the
pressure in our practice has been unrelenting. Not only are lots of
people demanding to be seen with what turn out to be trivial or self-
limiting viral illnesses (there's an unpleasant but pretty harmless bug
around at the moment - and I think I'm going down with it!), but there
is always the possibility that the next patient, perhaps one with a
typically nondescript history at first sight, might turn out to have
something serious.

On Mondays I typically see 35+, mostly minor, cases in the morning
emergency surgery (patients ring up, and if they say their problem is
urgent, they are fitted in, whatever). A high proportion turn out to be
trivial, but occasionally something serious turns up. I've admitted MIs,
crescendo angina, acute abdomens and meningitis cases from this surgery.
When you're on patient number 23 and there are still 12 or 13 to go
before "lunch"  (i.e. "quick sandwich") time, it's hard to
simultaneously stay alert, keep things moving and be pleasant. I try,
but sometimes I'm a bit brusque.

So far (touches wood) I haven't caused a disaster but, thinking back to
the last meningitis case (a year old boy), I was pretty ratty that
morning, the parent was a known worrier, and afterwards, instead of the
parents' effusive thanks for my spot on diagnosis and immediate
treatment, they could have been complaining about me or sueing me. I
know this for a fact, because I'd already decided there wouldn't be
anything serious wrong with the child before his mother brought him in,
and wasn't well disposed towards her. If I'm honest, I think I was
lucky, because I just happened to spot the beginnings of the petechial
rash. I still occasionally feel anxious about what might have happened.

Is it possible for us get through the volume of work we have these days
and never make a mistake or be insensitive to our patients? I doubt it,
and that distresses me more than I can say.

Toby
--
Toby Lipman 7, Collingwood Terrace, Jesmond, Newcastle upon Tyne. Tel 0191-
2811060 (home), 0191-2869178 (surgery)


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